Ethan
Patient Cost Estimation Agent
Patients want to know what a procedure will cost before they schedule it. Ethan gathers the benefits, deductible status, and rate logic - and prepares a clear estimate explanation so your staff can give patients a confident answer.
Where the problem lives today
Estimates require pulling from multiple sources
Patients wanted cost estimates before scheduling procedures, but estimates required combining benefits, deductible status, payer rules, provider rates, procedure details, and location-specific pricing.
Staff had to navigate systems while talking to patients
Call-center staff had to navigate several systems while explaining complex information to patients.
Slow or unclear estimates create real consequences
Slow or unclear estimates created patient frustration and increased call time.
Inconsistency undermines confidence
When estimate explanations vary by staff member or call, patients lose confidence in the number they receive - and price-sensitive procedures get abandoned before they are ever scheduled.
What Ethan does
Ethan supports patient-facing estimate workflows by gathering the right information, applying rate logic, and preparing a clear estimate explanation - so staff can give patients a confident answer without navigating multiple systems mid-call.
Gathers Procedure and Patient Details
Collects procedure details, patient benefit information, and deductible status needed to prepare the estimate.
Checks Benefit and Deductible Information
Checks benefit and deductible information against payer rules and coverage details before applying rate logic.
Applies Rate Logic
Applies provider rates, payer-specific rules, and location-specific pricing to calculate the estimate.
Prepares a Clear Estimate Explanation
Delivers a clear estimate explanation - not just a number, but a structured breakdown staff can use to walk patients through the cost confidently.
Assists Staff or Interacts Directly with Patients
Ethan can assist staff during calls or interact directly with patients in a controlled experience - depending on how the team chooses to deploy him.
Maintains Full Traceability on Every Estimate
Every estimate includes source data, assumptions, and traceability - so staff and supervisors can see exactly how the number was calculated.
Works Inside Your Existing Systems
Ethan connects to the benefits verification systems, payer rate tables, procedure databases, and patient access platforms your team already uses.
Your team stays in control
Patient access teams can manage the following:
Measured Impact
Lower average call handling time
Improved patient confidence before scheduling
Better consistency in estimate explanations
Reduced abandonment for price-sensitive procedures
What's Next
Once Ethan proves himself on patient estimate support, the same governed approach extends across other healthcare workflows. Insurance verification, referral coordination, prior authorization support, patient communication management, billing inquiry handling - and countless other processes that still depend on people to handle work that is largely repetitive and rule-based, rather than focusing on higher-value patient interactions.
Your staff shouldn't be navigating multiple systems while a patient waits on the line for a cost estimate.
See how Ethan gathers benefits, applies rate logic, and prepares a clear estimate explanation - so your staff gives patients a confident answer without the system juggle.